Glaucoma.pptx

REW

1. الاستاذ المساعد الدكتورة وداد كامل محمد Assessment and Management of Patients with Eye Disorders

2. Glaucoma Refers to a group of ocular conditions characterized by optic nerve damage. A condition of elevated IOP . The optic nerve damage is related to the IOP caused by congestion of aqueous humor in the eye.

3. Is the 2 nd leading cause of blindness in adult in the US. Is more prevalent in people older than 40 yrs. of age. There is no cure for glaucoma , but this disease can be control. Glaucoma

4. Family history Thin cornea Older age D.M. Cardiovascular disease Eye trauma Prolong use of corticosteroids Myopia Risk Factors

5. There are 2 theories regarding how increase IOP damage the optic nerve in glaucoma. The direct mechanical theory suggested : High IOP damages the retinal layer as it passes through the optic nerve head. Pathophysiology

6. The indirect ischemic theory suggested that high IOP compresses the microcirculation in the optic nerve head, resulting i n cell injury and death. Pathophysiology

7. Open angle glaucoma Angle-closure glaucoma Congenital glaucoma and Glaucoma associated with other condition, such as developmental anomalies or corticosteroid use . Classification of Glaucoma

8. “Silent thief of sight” Most pts. Are unaware that they have the disease until they have experienced visual changes and vision loss . Blurred vision or “ halos ” around lights , difficulty focusing , loss of peripheral vision , aching or discomfort around the eye and headache . Clinical Manifestations

9. Ocular and medical history must be detailed to investigate the history of predisposing factors. Tonometery to measure the IOP. Ophthalmoscope to inspect the optic nerve. Gonioscopy to examine the filtration angle of the anterior chamber Perimetry to assess the visual fields. Assessment and diagnostic findings

10. The aim of all glaucoma treat. Is prevention of optic nerve damage. Pharmacological therapy (miotics). laser trabeculoplasty) ) Laser procedures surgery or a combination of these approaches Medical Management

11. Is a lens opacity or cloudiness. Cataract affecting 40 yrs old of age. Cataract is the leading cause of blindness in the world. Cataract

12. Pathophysiology : Cataract can develop in one or both eyes at any age. Three common type of cataract are define by their location in the lens: 1. Nuclear 2. Cortical 3. Posterior subcapsular Cataract

13. Visual impairment depends on their : Size Density Location in the lens More than one type can be present in the eye. Cataract

14. A nuclear cataract : tends to have a substantial genetic component that causes a central opacity in the lens. It is associated with myopia. A cortical cataract : involves the anterior, posterior, or equatorial cortex of the lens. Vision is worse in very bright light. Posterior subcapsular cataract : occur in front of the posterior or equatorial cortex of the lens. Cataract

15. Aging Loss of lens transparency Decreased oxygen uptake Decrease in level of vitamin C, protein Increase in sodium and calcium Accumulation of a yellow- brown pigment due to the break-down of lens protein Risk factors

16. Associated ocular conditions Retinitis Myopia Retinal detachment and surgery Infection Risk factors

17. Toxic Factors Ionizing radiation Aspirin use Corticosteroids Alkaline chemical eye burns, poisoning Cigarette smoking Calcium, copper , iron, gold, sliver, and mercury Risk factors

18. Nutritional factors: Reduced level of antioxidants Poor nutrition Obesity Risk factors

19. Physical factors Dehydration Blunt trauma Electrical shock Perforation of the lens with sharp object or foreign body, Ultraviolent radiation in sunlight and x-ray Risk factors

20. Systemic Diseases and Syndrome Diabetes Down Syndrome Renal disorder Disorder related to lipid metabolism Musculoskeletal disorder Risk factors

21. Painless Blurred vision Diplopia Reduce visual acuity Astigmatism: refractive error due to an irregularity in the curvature of the cornea. Clinical Manifestation

22. The Snellen visual acuity test. Ophthalmoscope Slit lump examination. Assessment and Diagnostic findings

23. Medications, eye drops, eye glasses treatment cures cataract or prevents age-related cataract. In the early stage of cataract development, glasses, contact lenses, may improve vision. Medical Management

24. Intracapsular cataract Extraction: Extracapsular cataract Extraction: Phacomulisification: Lens Replacement: Surgical Management

25. Providing preoperative care: Withhold any anticoagulation(e.g. aspirin, warfarin) to reduce the risk of hemorrhage. Dilating drops are administer every 10 minutes for 4 doses at least one hour before surgery. Nursing management

26. Providing postoperative care: The patient receive verbal and written I nstruction about how protect the eye A dminister medication R ecognizes the signs of complications and o btain emergency care. I nstruct the patient to take a mild analgesia agent , as needed. A nti-inflammatory and corticosteroid eye drops or ointment. Nursing management

27. Teaching patient self care: Eye patch for 24 hrs. after surgery. followed by eye glasses worn during the day,. Sunglasses should be worn. A clean , damp wash cloth may be used to remove eye discharge. Promoting home and community-based care

28. Eye patch remove after the first follow up appointment . Vision is stabilized when the eye healed, usually within 6-12 weeks. Continuity care